While self-directed support for people with disabilities and their families represents a welcome shift toward self-determination and increasing control, the risk of managing with insufficient funds remains. This article examines whether different types of case management can mitigate that risk by providing support when people have only a small direct funding package. It applies the question to an evaluated program of self-directed support in Queensland, Australia that allocated A$4000 with one of two approaches to case management: program-focused or organizationally oriented. Case management contributed to the effective use of limited budgets and addressing goals when it promoted choice and control, built relationships, and enabled flexible fund use. Program-focused case management seemed to be less constrained in enhancing social participation than organizationally oriented case management, which tended to restrict some participatory opportunities. These findings are consistent with earlier research, which indicated that case management can interfere with participation. Even in the context of a small funding allocation, a case management approach that promotes flexibility and person-centered planning, control over funding, and capacity building can improve the effectiveness of self-directed support; however it does not overcome the inherent limitations of insufficient funds for adequate support, or the cost of case management itself.

中文翻译：

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案例管理是否有助于有效使用针对残疾人的小型自我指导支持包？

虽然对残疾人及其家人的自主支持代表着向自决和加强控制的可喜转变，但管理资金不足的风险仍然存在。本文研究了当人们只有少量直接资金时，不同类型的案例管理是否可以通过提供支持来降低这种风险。它将问题应用于澳大利亚昆士兰州的一项自我指导支持评估计划，该计划拨款 4000 澳元，用于案例管理的两种方法之一：以计划为中心或以组织为导向。案例管理在促进选择和控制、建立关系并实现灵活的资金使用时有助于有效利用有限的预算和实现目标。以项目为中心的案例管理似乎比以组织为导向的案例管理在加强社会参与方面受到的限制更少，后者往往会限制一些参与机会。这些发现与早期的研究一致，这表明案例管理会干扰参与。即使在资金分配较少的情况下，促进灵活性和以人为本的规划、资金控制和能力建设的案例管理方法也可以提高自主支持的有效性；然而，它并没有克服资金不足而无法提供足够支持的固有限制，或案件管理本身的成本。这表明案例管理会干扰参与。即使在资金分配较少的情况下，促进灵活性和以人为本的规划、资金控制和能力建设的案例管理方法也可以提高自主支持的有效性；然而，它并没有克服资金不足而无法提供足够支持的固有限制，或案件管理本身的成本。这表明案例管理会干扰参与。即使在资金分配较少的情况下，促进灵活性和以人为本的规划、资金控制和能力建设的案例管理方法也可以提高自主支持的有效性；然而，它并没有克服资金不足而无法提供足够支持的固有限制，或案件管理本身的成本。